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Congress, Administration Work to Meet Growing Need for Behavioral Health Care

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…Services In response to these troubling trends, policymakers are seeking multi-pronged approaches to provide greater access to services that treat and manage mental health and substance use disorders (MH/SUD). The five Congressional committees with jurisdiction over health legislation have all held multiple hearings on behavioral health over the last year. Additionally, the Senate Finance committee released a comprehensive report that…

April Research Roundup: What We’re Reading

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…each year, comparing this data at the hospital referral region (HRR) and national level. What it Finds Commercial health plans pay much more for hospital care than public payers, and although average commercial-to-Medicare price ratios were relatively stable during the study period, researchers found variation across geographic regions. Between 2012 and 2019, price ratios increased by an average of 7…

Response to Deceptive Marketing of Limited Plans Shows States Can Take Proactive Steps to Protect Consumers

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…in November 2021, when Massachusetts called the company out in a Consumer Alert about unlicensed carriers that had generated consumer complaints. Wisconsin ordered a cease and desist against Salvasen in January 2022. Salvasen also faced pressure from several state departments of insurance (DOIs) to cease operations following the company’s decision to self-report compliance issues in June 2021. The company agreed…

Fixing the Family Glitch: Federal Rules Aim to Improve Coverage Affordability for Working Families

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…to remove this barrier will make coverage more affordable and accessible for families of low and moderate-income workers, including those working for small businesses. What is the family glitch? The ACA ‘s health insurance marketplaces provide comprehensive coverage and financial assistance for people who do not have affordable employer coverage and do not qualify for public insurance. Workers whose employers…

Mitigating Coverage Loss When the Public Health Emergency Ends: The Role of the Affordable Care Act Marketplaces

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…depend largely on marketplace officials. In a new post for the Commonwealth Fund’s To the Point blog, CHIR’s Sabrina Corlette and Maanasa Kona discuss the important role that ACA marketplaces will play in mitigating coverage losses. Their piece identifies basic as well as more innovative strategies marketplaces can adopt to help consumers make a smooth transition to affordable, comprehensive coverage….

Updated Breast Pump Coverage Guidelines Provide Important Protections for Families but More Guidance May Be Needed to Increase Access

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…six months and breastmilk among other foods until they turn at least one, despite the health benefits for both infant and parent (including protection from COVID-19). I’ve also come to really appreciate the Affordable Care Act (ACA) requirement that (most) health insurance plans cover breastfeeding services and supplies without any cost sharing. Although an array of policy interventions are needed…

The End of the Public Health Emergency Will Prompt Massive Transitions in Health Insurance Coverage: How State Insurance Regulators Can Prepare

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…the Affordable Care Act (ACA) Marketplaces. These shifts would represent the largest change in coverage status since implementation of the ACA. Whether a state’s Medicaid agency moves swiftly or slowly to process eligibility redeterminations, the commercial insurance market–and particularly the ACA Marketplaces–could experience a significant growth in enrollment. In a new issue brief for the State Health & Value Strategies…

New Georgetown Report on Medicaid and Marketplace Network Adequacy

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For health insurance to be meaningful, enrollees must have access to providers that can meet their health care needs. Yet a new study from Georgetown University’s Center on Health Insurance Reforms (CHIR) and Center for Children & Families (CCF) evaluated federal and state standards for network adequacy across Medicaid and the Marketplaces and found that access to providers can vary…

California’s Marketplace Tries New Tactics to Reduce the Number of Uninsured and Underinsured

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…have insurance are “underinsured,” unable to access care because of high cost sharing. Reducing the barriers that lead to people being uninsured and underinsured requires innovative policies to simplify enrollment and help consumers access more generous plans that fit their budget. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR’s Rachel Schwab, Justin Giovannelli, and Kevin…

The Expiration of the Public Health Emergency Also Ends Policies to Lower Health Access Barriers

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…care for Medicare beneficiaries during the last two years; nearly 30 million beneficiaries used telehealth during the first year of the pandemic, approximately two in five beneficiaries. Last month, Congress extended certain telehealth flexibilities for 151 days beyond the end of the PHE and directed the Medicare Payment Advisory Committee (MedPAC) and the HHS Office of Inspector General to issue…

The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.